I was recently sick to my stomach and ordered to the ER by my doctor. While in triage, they ran my credit card for my copay. After discovering how sick I was, and once my payment cleared, they admitted me into the hospital – where I spent the next 36 hours.

I received the bill last week. The total cost was $18,000 – give or take a few bucks.

I spent two nights in the hospital. Had one CT scan. Received a few bags of antibiotics along with a few hits of morphine. They ran tests on my blood, urine and stool. I spoke with doctors for a total of about 30 minutes. I was on a clear liquid diet but for my last meal. $18,000.

Our insurance hasn’t kicked in yet, but we expect to be responsible for anywhere from a several hundred dollars (beyond my $150 ER copay) to a few thousand for my 36-hour visit. Our annual maximum out-of-pocket is $6,000, and we pay about $700 per month just for our family to have insurance. Next to our children being born, and once about ten years ago when our oldest daughter was admitted for two days for respiratory issues, none of us have ever been hospitalized. Until my trip.

Nothing was mentioned about costs when they said I needed to be admitted into the hospital. Before I agreed though, I did ask what might happen if I refused further treatment (spending a night in the hospital was not high on my bucket list) and was told that if I refused treatment, I would be going against doctors advice (ADA) and that the insurance company would probably refuse to pay for any of the testing leading up to their decision to admit me. I thought this was a strange answer because what I meant was what might happen to me physically if I weren’t admitted. Anyway, I was writhing in pain, and certainly didn’t want to piss off the insurance company, so I accepted my fate as a resident in the hospital. For two nights.

$18,000.

For $18,000, I can take my family to the top hotel at Walt Disney World for a whole month – park tickets and all meals included. In the hospital for that day-and-a-half, I ate jello, had basic cable, and the only ride was on a gurney.

Maybe the medicine they gave me was just really expensive? Yes, that had to be it. I started feeling better after being treated with antibiotics. Except, when I picked up the antibiotics from the pharmacy the morning I was released, the total cost for the seven-day supply – was twelve bucks.

There’s something wrong here, America. Sure, I may be spared much of the $18,000 because the insurance company and the hospital have lawyers hard at work determining what kinds of things are covered for various conditions. There are, however, no lawyers working for me. I’m just a little pawn in this power play. Not only do I pay every month for the privilege to even have insurance, but when I need to depend on my monthly investment in it – I’m ultimately at the will of lawyers and doctors who decide how much more I’ll need to pay. And if I disagree, it’s up to me to fight with either the insurance company or the hospital (or both.) Yeah, that’s not time (money) consuming.

I’m no insurance expert, and I’m clueless about medicine. Yet somehow, this ignorance is an actual opportunity for capitalistic ventures. Even ones that capitalize on my fallibility as a biological machine that sometimes breaks down. Healthcare in America is no different than selling cars. The only thing that matters if profit. And this breaks my heart. Somehow healthcare has become a political issue where people are elected based on whether they side with the rich and powerful, or the poor and weak who are force-fed fast food and end up hospitalized as a result. We’re humans. We break. Any capitalistic ventures that exist as the result of our fallibilities should be regulated by a government that punches special interests in the mouth. If you make a pill that expedites cancer treatment, why should only the rich and powerful receive it? And if you’re not rich and powerful and still receive it, you’re stuck paying for the opportunity to live – since you become indebted to the company who has figured out how to fix the biological machine that keeps you breathing. When did we start raising generations of doctors and scientists who are only in it for the money? Where’s the humanity? Or ethics?

Thankfully, my trip to the hospital probably won’t break me and my family. My visit was only for 36-hours. But imagine someone who has terminal illness? Or someone who doesn’t have insurance at all? We pay a lot for insurance. But I’d venture to guess that, based on their appearance, most of the people in the ER that day did NOT have insurance. Were they denied treatment? No. Were they admitted into the hospital? Unless they absolutely need to be, I’d guess that the answer to that question is also no. Were these people billed for services rendered? Well, the ones who had actual mailing addresses probably were. Could those without insurance pay directly like I did when I was in triage? Unlikely. Which means that they will spend the rest of their lives (or until they can pay for the services in full) in debt to the hospital. If they can’t, they can forget about ever getting credit to buy a car or a house or getting a loan to go to college. Or, if they are ever extended credit despite their debt to the hospital, the banks will see that as an opportunity to do their thing and charge special interest rates that are virtually impossible to pay off.

There’s a lot of things wrong in this country. And I just stepped into the middle of one of them. $18,000 later, I’m sick to my stomach again.

Jim Mitchem

Thanks for sharing this story. As horrible as your situation sounds, it is just another brick in the sick system that we know has healthcare in the US. The answer is not the Obamacare – and the answer is not ‘business as usual’. What is needed is a complete overhaul of the system without the political parties, lobbyists, and special interest groups. But what can bring that about besides a clearing of the decks and starting from step one?

I hope that you are feeling better. Just to let you know that I often benefit from your posts and insights. Your love of family shines through your posts which humanizes your other cryptic (and often non cryptic) remarks.

It’s an eye opener. When the doctor gave me the diagnosis of being Alpha 1 http://www.alpha1.org/ (from a blood test) he mentioned that the therapy for it would be about $30,000 US per year (or Month I forget) if things started going in the wrong direction for me ( he said I was a carrier of the gene – doesn’t mean it will progress but doesn’t guarantee that it wont). My Father in law is going through his second round of Cancer treatments at $5000.00 US a pop. Yeah we do have something wrong with the system that we are in. Even though I have insurance and my FIL has the VA and disability and other coverage, it just frustrates you to think that there are those who can’t get any treatment at all, and people still want to block universal health care.

Healthcare costs are the biggest driver of bankruptcy. Imagine if you had poor insurance or no insurance.

Or, even more heart breaking, imagine if you had already reached your full annual or lifetime payout limit because of someone in your family having cancer or being in a bad car wreck or being born with a disability. These payout limits are commonly 1 or 2 million. As someone who has seen a $400,000 hospital bill, that limit can be reached more easily than most realize.

Once I had a lump in my breast. I went into a hospital (in my network) to have surgery by my doctor (in my network). About 4 weeks later I received a bill by the anesthesiologist (who put me under for the surgery) for about $4000. Guess what? He wasn’t in my network! So even though I tried to follow the rules by staying in network with my ^wonderful^ Federal employee plan…I still got stuck with a crazy bill because I was not savvy enough to ask the guy putting me under if he was in my network! Crazy and messed up healthcare BUSINESS. When you are ill, you don’t always think to ask if everyone who touches you is in network or if the procedure is covered…and the doctors certainly don’t know or have time to check.

Unfortunately $18K ain’t bad. I needed a very common, very short (half an hour to 45 minute) procedure. With no insurance I shopped my two local hospitals. The “nicer” hospital wanted $15, 728 for me to be in their outpatient area a total of 3 hours. One hour to get prepped, one hour for the procedure, one hour for recovery. The other “public” hospital charged $25K. Yes, I did not stutter, $25,000 for the same 3 hours. That’s because as a “not for profit” facility much like where you were, they have to accept and treat all who enter. And guess who helps pay for it?
In my case I went back to my physican who did an in office invasive test which came back negative. Am I 100% certain the test was 100% accurate…well, only time will tell.